The Real Cost of Medical Mistakes

Risk & Insurance, April 1, 2001 by Lori Widmer

Employer Initiatives

The Institute of Medicine report, To Err Is Human: Building a Safer Health System, advocates change through and open and voluntary reporting system in hopes that errors can be reduced through examining them. Hastings thinks the suggestion is a good one, but if implemented could have serious side effects. "Open reporting can greatly increase the liability exposure not only to doctors and health plan but possibly also the employer. The question is how do you create a more openly reporting and blame-free environment to allow people to self correct, while at the same time not increasing everyone's liability?"

One way, adds Hastings, is to protect the medical community's open culture through laws designed to protect the confidentiality of the information. "The IOM report speaks to that. They talk about voluntary reporting and perhaps needing a law to make sure that all the internal reporting information that will help to reduce errors will be confidential and can't be used in lawsuits. But that would be hard to achieve in our legal system."

Employer coalitions have also become more prevalent. The Leapfrog Group in Washington has attacked specifically the problem of medical errors. Suzanne Delbanco is executive director of the group, which is comprised of nearly 70 corporations including Fortune 500 companies. "The group was formed informally three years ago by people who were frustrated at not seeing the breakthroughs in quality health care that they expected," says Delbanco. "When you've got close to 100,000 people dying from medical mistakes yearly, someone's got to do something about it. We really don't have a good grip on what the implications are. We don't even know how many errors are occurring on the outpatient setting, which is probably even more vast."

Other employers are tackling the issue as well. The National Business Coalition on Health (NBCH) and the Midwest Business Group on Health (MBGH) are beginning research efforts addressing medical mistakes. The NBCH provides resources for more than 100 coalitions across the country. These business coalitions represent more than 8,000 employers and more than 34 million employees. The MBGH's coalition of employers in 11 states works toward improving the quality and cost of health care.

Leapfrog Group has outlined three initial methods to improve patient safety--computer physician order entry, evidence-based hospital referral, and ICU physician staffing. Leapfrog contends that these standards have scientific backing. "We commissioned an independent study conducted by Dartmouth," says Delbanco. "They found that if every nonrural hospital in America were to institute the three Leapfrog safety standards, we would prevent more than half a million medical errors a year and we would probably save close to 60,000 lives."

"Industry should support efforts to reduce medical errors," says Hastings. "It can mean holding health plans accountable. Make sure health plans as well as employees are high quality. Employers can champion that without increasing their liability."